α-Ketoglutaric acid (AKG) is an organic compound with the formula . A white, nontoxic solid, it is a common dicarboxylic acid. Relevant to its biological roles, it exists in water as its conjugate base α-ketoglutarate. It is also classified as a 2-ketocarboxylic acid. β-Ketoglutaric acid is an isomer. "Ketoglutaric acid" and "ketoglutarate", when not qualified as α or β, almost always refers respectively to α-ketoglutaric acid or α-ketoglutarate.

α-Ketoglutarate is an intermediate in the citric acid cycle, a set of cyclic reactions that supplies energy to cells. It is also an intermediate in or product of several other metabolic pathways. These include its being a component of metabolic pathways that: make amino acids and in the process regulate the cellular levels of carbon, nitrogen, and ammonia; reduce the cellular levels of potentially toxic reactive oxygen species; and synthesize the neurotransmitter γ-aminobutyric acid (GABA).

A large body of preclinical (i.e., conducted in animal models of disease or on animal or human tissues) research has been conducted on the role of endogenous (generated within the body) α-ketoglutarate. A small amount of preclinical research has been done to determine the effects of providing additional exogenous α-ketoglutarate to biological systems. There is currently no randomized controlled trials showing α-ketoglutarate to have any pharmacological (drug-like) effects on humans. The Food and Drug Administration classifies α-ketoglutaric acid as "503A Category 3: Bulk Drug Substances Nominated Without Adequate Support".

Production Citric acid cycle α-Ketoglutarate is a component of the citric acid cycle, a cyclical metabolic pathway located in the mitochondria. This cycle supplies the energy that cells need by sequentially metabolizing (indicated by →) citrate through seven intermediate metabolites and then converting the eighth intermediate metabolite, oxaloacetate, back to citrate:

citrate → cis-aconitate → isocitrate → α-ketoglutarate → succinyl-CoA → succinate → fumarate → malate → oxaloacetate → citrate

In this cycle, the enzyme isocitrate dehydrogenase 3 converts isocitrate (isocitrate has 4 isomers of which only the (−)-d-threo-isomer is the naturally occurring isomer in the citric acid cycle.) to α-ketoglutarate which in the next step is converted to succinyl-CoA by the oxoglutarate dehydrogenase complex of enzymes.

Glutaminolysis and transamination Aside from the citric acid cycle, α-ketoglutarate is made by glutaminolysis in which the enzyme glutaminase removes the amino group from glutamine to form glutamate which is converted to α-ketoglutarate by any one of three enzymes, glutamate dehydrogenase, alanine transaminase, or aspartate transaminase (see The glutaminolytic pathways).

It is also made through the action of pyridoxal phosphate-dependent enzymes (alanine transaminase) in which glutamate is converted to α-Ketoglutarate by "donating" its to other compounds (see transamination).

These reactions are reversible. In the reverse direction of these reactions, α-ketoglutarate contributes to the production of amino acids such as glutamine, proline, arginine, and lysine as well as the lowering of cellular carbon and nitrogen (i.e., N) levels; this prevents excessive levels of these two potentially toxic elements from accumulating in cells and tissues.

The neurotoxin, ammonia (i.e., ), is also prevented from accumulating in tissues. In this metabolic pathway the group on an amino acid is transferred to α-ketoglutarate; this forms the α-keto acid of the original amino acid and the amine-containing product of α-ketoglutarate, glutamate. The cellular glutamate passes into the circulation and is taken up by the liver where it delivers its acquired group to the urea cycle. In effect, the latter pathway removes excess ammonia from the body in the form of urinary urea.

Functions

α-Ketoglutaric acid exerts its biological action in multiple ways. It is an agonist of the OXGR1 receptor. It is also a cellular antioxidant and a cofactor for certain enzymes.

OXGR1 receptor-dependent bioactions OXGR1 (also known as GPR99) is a G protein-coupled receptor, i.e., a receptor located on the surface membrane of cells that binds certain ligands and is thereby stimulated to activate G proteins that elicit pre-programmed responses in their parent cells. OXGR1 was identified as a receptor for: a) α-ketoglutarate in 2004; b) three leukotrienes viz., leukotrienes E4, C4, and D4 in 2013. and c) itaconate in 2023. These ligands have the following relative potencies in stimulating responses in OXGR1-bearing cells (Note that LTE4 can stimulate OXGR1 at concentrations far lower than those of the other four ligands):

LTE4 >> LTC4 = LTD4 > α-ketoglutarate = itaconate.

It may be difficult to determine if an OXGR1-stimulating agent elicits a functional response by activating OXGR1 as opposed to some other mechanism. To make this distinction, studies have shown that the action of an OXGR1-activating agent on cultured cells, cultured tissues, or animals does not occur or is reduced when these cells, tissues, or animals have been altered so that they do not express or express greatly reduced levels of the OXGR1 protein, or when their actions are inhibited by an OXGR1 receptor antagonists. OXGR1 is inhibited by montelukast, a well-known inhibitor of the cysteinyl leukotriene receptor 1, i.e., the receptor for LTD4, LTC4, and LTE4. Montelukast also blocks the binding of these leukotrienes to, and thereby inhibits their activation of, OXGR1. One study presented evidence suggesting that α-ketoglutarate binds to OXGR1. It is assumed that montelukast similarly blocks α-ketoglutarate's binding to, and thereby inhibits its activation of OXGR1.

Kidney functions The pendrin protein promotes the electroneutral exchange of tissue chloride (Cl−) for urinary bicarbonate (HCO3−) in the apical surfaces (i.e., surfaces facing the urine) of the kidney's renal β-intercalated cells (also termed type B intercalated cells) and non-α non-β intercalated cells (also termed non-A non-B intercalated cells) in the kidney's collecting duct system (i.e., CDS). A study in mice found that OXGR1 colocalizes with pendrin in the β-intercalated cells and non-α non-β intercalated cells lining the tubules of their kidney's CDS. The intercalated cells in the CDS tubules isolated from mice used pendrin in cooperation with the electroneutral sodium bicarbonate exchanger 1 protein to mediate the Cl− for HCO3− exchange. α-Ketoglutarate stimulated the rate of this exchange in CDS tubules isolated from control mice (i.e., mice that had the Oxgr1 gene and protein) but not in CDS tubules isolated from Oxgr1 gene knockout mice (i.e., mice that lacked the Oxgr1 gene and protein). This study also showed that the α-ketoglutarate in the blood of mice filtered through their kidney's glomeruli into the proximal tubules and loops of Henle where it was reabsorbed. Mice drinking water with a basic pH (i.e., >7) due to the addition of sodium bicarbonate and mice lacking the Oxgr1 gene and protein who drink water without sodium bicarbonate had urines that were more basic (i.e., pH about 7.8) and contained higher levels of urinary α-ketoglutarate than control mice drinking water without this additive. Furthermore, Oxgr1 gene knockout mice drinking sodium bicarbonate-rich water developed metabolic alkalosis (body tissue pH levels higher than normal) that was associated with blood bicarbonate levels significantly higher and blood chloride levels significantly lower than those in control mice drinking the sodium bicarbonate-rich water.

Several other studies confirmed these findings and reported that cells in the proximal tubules of mice synthesize α-ketoglutarate and either broke it down thereby reducing its urine levels or secreted it into the tubules' lumens thereby increasing its urine levels.

Another study showed that a) In silico computer simulations strongly suggested that α-ketoglutarate bound to mouse OXGPR1; b) suspensions of canal duct cells isolated from the collecting ducts, loops of Henle, vasa recta, and interstitium of mouse kidneys raised their cytosolic ionic calcium, i.e., Ca2+ levels in response to α-ketoglutarate but this response (which is an indicator of cell activation) was blocked by pretreating the cells with montelukast; and c) compared to mice not treated with streptozotocin, streptozotocin-induced diabetic mice (an animal disease model of diabetes) urinated only a small amount of the ionic sodium () that they drank or received by intravenous injections; montelukast reversed this defect in the streptozotocin-pretreated mice.

These results indicate that in mice: a) α-ketoglutarate stimulates kidney OXGR1 to activate pendrin-mediated reabsorption of sodium and chloride by type B and non-A–non-B intercalated cells; b) high alkaline (i.e., sodium bicarbonate) intake produces significant increases in urine pH and α-ketoglutarate levels and impairs secretion of bicarbonate into the CDS tubules' lumens; c) the acid–base balance (i.e., levels of acids relative to their bases) in the face of high alkali intake depends on the activation of OXGR1 by α-ketoglutarate; d) alkaline loading directly or indirectly stimulates α-ketoglutarate secretion into the kidney's proximal tubules where further down these tubules it activates OXGR1 and thereby the absorption and secretion of various agents that contribute to restoring a physiologically normal acid-base balance; and e) α-ketoglutarate stimulates OXGR1-bearing CDS cells to raise their levels of cytosolic Ca2+) and in diabetic mice (and presumably other conditions involving high levels of blood and/or urine glucose) to increase these cells uptake of .

Resistance exercise and muscle atrophy